What is EMDR therapy and why combine it with CBT & biofeedback therapy?

What is EMDR therapy and why combine it with Cognitive Behavior Therapy and biofeedback therapy?

Eye Movement Desensitization and Reprocessing (EMDR) is multi-phase (8) form of therapy. It is based on the theory of information processing. Information processing theory says multiple elements (thoughts, feelings, images) of an experience are stored as memories in accessible and useful forms in the brain. However since emotions and cognitions are stored in different places in the brain…. what you know and what you feel are sometimes very different!

Thus, EMDR sessions focus on reprocessing the information associated with past, present or future experiences that are experienced in an overly emotional or negative way. These targeted experiences are often associated with pathologies such as phobias, panic disorder, PTSD and depression.

Emdr sessions involve tapping into present feelings and thoughts about past and future events by using:

Images

Smells

Sounds

Body Sensations

Emotions

Negative cognitions*

Negative cognitions are the irrational beliefs held on to by the patient as a result of the past event. These types of beliefs are very damaging because they usually reinforce and mimic the person’s thought style in other areas of life. The level of insight and willingness to make changes varies from person to person but EMDR can help the person gain insight and reduce the level of spontaneous reactions in similar situations.

Why Combine EMDR , CBT and Biofeedback?

Combined with Cognitive Behavior Therapy the person can begin to integrate healthy ways of thinking into everyday life. Biofeedback therapy helps to integrate the calmer body sensations into life as well.

Without insight and perhaps therapy, often it will be the case that the beliefs of the pasts will be repeatedly played out in the future/ present. (I was not safe then so I must protect myself NOW . I experience myself as unsafe NOW and therefore I cannot trust.)

Eye movements:During the session, the therapist uses the information provided by the patient to help them re-assess the stuck material by connecting them to different parts of their brain. Eye movements are used to neurologically stimulate both sides of the brain so that images, feelings, negative cognitions become desensitizezed*

How do the eye movements help this? Is this part really necessary?

Yes, the eye movements or other forms of bilateral stimulation are necessary because…

Research has shown that bilateral stimulation of the brain helps to engage the autonomic nervous system into a –state- of- relaxation (increasing para-sympathetic arousal and increased HRV- These are great things!). This activation of the relaxation side of the nervous system can then become active in assisting in the desensitization process of the event.

Goals:

The first goal is to reduce the patients associated distress attached to the event

The second is to establish a habitual connection to the memory to a more positive or healthier thought and feeling

Emdr is effective for both large and small traumas. It’s has been shown to be effective in treating PTSD and phobias . Emdr therapy can be done as a solo therapy or as an adjunct to another therapy such as Cognitive Behavior Therapy, Biofeedback and Yoga Therapy.

A case example. where EMDR was particularly helpful in effectively treating a phobia- fear of flying. John is a 40 year old male patient with a history of moderate to severe flight anxiety. He will get on a plane but worries for days and even on the end of a vacation he will begin to ruminate about the flight home. In the past we have some done some CBT and virtual exposure around flying and he is a well-practiced breather. But he always held on to a small amount of the anxiety. In December we did 2 Emdr sessions about being on an airplane and he now automatically thinks “I will be safe enough) ever time he sees or boards an airplane. It also helps that he has been flying regularly and using his CBT while on the plane. But I really believe the EMDR sessions have given him that extra ability to let go.